Ingrown Hair (cont.)

Gary W. Cole, MD, FAAD

Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

What is the treatment for an ingrown hair?

Although an ingrown hair can heal on its own and spontaneously dislodge, in some cases, it may be tough to get rid of it. Available treatments include

chemical depilatories,

topical creams,

topical antibiotics,

medical removal of the ingrown hair by small incision and pulling out the hair,

hair-removal laser.

Best results may be achieved with combination therapy. Consulting a medical doctor who specializes in dermatology may be necessary for the optimal treatment of more severe cases.

Chemical depilatories like Neet or Nair can loosen the structure of hair, resulting in blunt tips of shaved hairs at the follicular opening. Chemical depilatories may be used every second or third day rather than every day due to the possible chemical irritation on the skin. Hydrocortisone cream can be applied to alleviate the irritation caused by chemical depilatories.

Tretinoin (Retin A) cream can help decrease skin plugging or hyperkeratosis. Topical tretinoin cream may thin out the epidermis, reduce the buildup of dead skin cells, and decrease hair embedding into the follicles. Topical corticosteroid creams with a mild strength can be applied to reduce inflammation of inflamed ingrown hairs.

Topical and oral antibiotics may be required for severe cases that form pustules and abscesses, which indicate secondary infection. Topical antibiotics, including erythromycin (E-Mycin, Ilosone) and clindamycin (Cleocin), topical antibacterial agents, such as benzoyl peroxide (Persa-Gel), and the combinations of topical antibiotics and antibacterial agent, can help reduce the growth of skin bacteria and treat secondary infection. Oral antibiotics, such as tetracycline (Sumycin) or cephalexin (Keflex, Keftabs), are used to control infected pustules or abscess formation. Antibacterial washes, such as benzoyl peroxide (Clearasil, Proactiv) or chlorhexidine (Hibiclens), can be used once or twice a day to control the infection. Topical eflornithine HCl 13.9% cream (Vaniqa) is a prescription that can reduce the rate of hair growth when applied to the skin twice a day over one to two months. Hence, it can be useful as long-term therapy in individuals with excessive facial hair or patients who have pseudofolliculitis barbae.

For skin discoloration, prescribed fading creams such as hydroquinone 4% (Eldoquin), kojic acid, azelaic acid 15%-20%, or over-the-counter fading creams with 2% hydroquinone can help improve any residual or persistent discoloration. Prescription of higher concentration of hydroquinone may also be formulated by compounding pharmacists to help particularly resistant skin discoloration.

Laser hair removal may be an option for preventing ingrown hairs. Laser treatments applied to an area help to permanently decrease the number of hairs. Currently, laser removal works primarily on dark hairs only. Laser hair removal is generally very fast, efficient, and safe. Laser treatment risks include skin discoloration.

Electrolysis may be used to permanently remove hairs. This procedure targets individual hair follicles and can be performed on any color of skin and any size and color of hair. The destruction of hair follicles is permanent. Electrolysis is often slow, tedious, and requires multiple treatments.